運用組合式環境清潔消毒作業降低加護病房感染密度

Reduction of Infection Density in Intensive Care Unit Through an Integrated Cleaning and Disinfection Operation Procedure

10.6530/YYN/2015.3.02

孫吟蓁(Yin-Jhen Sun)；簡伶育(Ling-Yu Chien)；許佳晴(Chia-Ching Hsu)；謝珮琦(Pe-Chi Hsieh)；康豑云(Chih-Yun Kang)；許瀚仁(Han-Jen Hsu)；曾雯琦(Wen-Chii Tzeng)

醫療抗菌濕紙巾 ； 環境清潔消毒 ； 感染密度 ； Medical antibacterial wipes ； environmental cleaning and disinfection ； infection density

源遠護理

9卷1期（2015 / 03 / 01）

45 - 55

繁體中文

院內感染代表將使得財務負擔增加及健康照護品質降低，然而，本單位外科暨神經外科加護病房多次名列全院感染密度最高單位，更於2013年11月竄升至千千分之14.7，高於全國平均千分之10.1。分析原因為缺乏環境清潔消毒標準化流程、稽核機制及環境清潔衛材管理不善。專案小組運用實證手法，採組合式環境清潔消毒作業，除建立標準化流程及稽核機制，更革命性地使用拋棄式清潔衛材及專屬抹布概念，降低交互感染疑慮。2013年11月至2014年4月感染密度由千分之14.7降至千分之8.4，除此之外，護理人員及清潔人員環境清潔消毒作業的正確率亦分別由65.8%至92.3%及由65.9%至88.6%；清潔衛材管理改善率則由30%提升至88.3%。此專案手法確能有效降低醫療照護相關感染密度，確保醫療照護品質。

Hospital acquired infections represent a declined quality of healthcare and an increased financial burden. The national average of infection density was 10.1‰. The intensive care unit (ICU) in the study was higher than average and peaked at 14.7‰ in November 2013. Root cause analysis identified improper management of the cleaning equipment, lack of a standard procedure for disinfection, and no auditing process. The project team designed and implemented an integrated cleaning and disinfection procedure that included the use of disposable cleaning equipment and a concept of exclusive cleaning rag. The infection density was reduced from the November 2013 peak to 8.4‰ in April 2014. The cleaning operation accuracy increased from 65.8% to 92.3% for nursing staff, and from 65.9% to 88.6% for cleaning staff. The project effectively improved medical care quality and reduced the healthcare associated infection.

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